One in four people in Ireland will experience a stroke during their lifetime. That's a worrying statistic. However, there is a lot we can do to avoid having this life-threatening medical emergency.
Up to 90 per cent of strokes can be prevented by managing key risk factors including high blood pressure, smoking, obesity, physical inactivity, and an unhealthy diet.
Beatriz Gómez Maestre, a stroke services co-ordinator with the local heart and stroke charity, Croí, explains a stroke occurs when one of the blood vessels that supplies blood, oxygen, and nutrients to the brain is interrupted either by a blockage or a bleed. As a result, brain cells are deprived of what they need to function and become damaged.
There are two main types of stroke - Ischaemic and Haemorrhagic. An Ischaemic stroke occurs when a blood clot or plaque build-up in the artery blocks the flow of blood to part of the brain. This is the most common type of stroke, accounting for about 85 per cent of cases. Haemorrhagic strokes, also known as cerebral haemorrhages, are less common and happen when the blood flow is interrupted by the rupture of a blood vessel in the brain, causing bleeding in or around it.
Some people experience a transient ischaemic attack (TIA ) or mini stroke. It is caused by blood temporarily being unable to get to part of the brain, resulting in a lack of oxygen. This disruption can cause symptoms similar to a stroke, for example, speech and visual problems or numbness or weakness in the face, arms, or legs. The effects last a few minutes to a few hours and stop within 24 hours. However, mini strokes act as a warning sign of a possible stroke in the future.
She says it is important to be aware of the telltale signs of stroke and to act quickly if you suspect someone is having one. "An easy way to remember the main warning signs is with the term BE FAST:
F-ace: Can the person smile? Has their eye or mouth drooped? Does one side of their face feel numb?
A-rm Weakness: Is one arm weak, drooping, or numb? Ask the person to raise both arms, does one arm drift down?
S-peech: Ask the person to answer a simple question, like where they are right now. Is their speech slurred or jumbled up? Do they understand you? Do they have difficulty finding the words?
T-ime: It is time to call 112 or 999 if you see any of these signs, even if they have disappeared. Time is critical."
Some people may experience different signs, such as a sudden loss or blurring of vision, a loss of balance or sudden weakness, or a feeling of numbness on one side of the body, not just in the arm.
Admitted to hospital
The number of people experiencing, and being admitted to hospital, yearly with stroke has increased by 13 per cent since 2021, she says. The HSE estimates that about 7,500 people have a stroke each year - there are no local figures available. It is the third leading cause of death and the leading cause of acquired neurological disability.
While it is more common in older people, it is important to remember that it can happen at any age. The HSE notes that about one in four strokes occur in people under 65 years. More men appear to be affected; in 2020, 57 per cent of stroke cases involved men and 43 per cent occurred in women.
Prevention should be at the heart of our approach to stroke, according to Ms Gómez Maestre, an occupational therapist and exercise physiologist. "The more people understand about their risk factors and the steps they can take to reduce them, the greater our opportunity to prevent strokes from happening in the first place.
"A risk factor is anything that increases a person’s likelihood of having a stroke. Some risk factors are things we cannot change, while others can be influenced by the way we live and the choices we make. I like to think of the non-modifiable risk factors as a backpack we are given when we are born. We don’t get to choose what’s in it. This can include our age, sex, family history, and ethnicity. We can’t change these factors, but knowing about them can help us understand our individual risk.
"Then, there are modifiable risk factors, the things we can potentially influence through lifestyle changes and medication. These include high blood pressure, high cholesterol, diabetes, and atrial fibrillation, as well as smoking, excessive alcohol consumption, physical inactivity, an unhealthy diet, stress, poor sleep, and obstructive sleep apnoea."
The important message, she says, is that understanding our risk factors give us an opportunity to take action where we can, and, ultimately, reduce our risk of stroke.
She believes there is a need for greater awareness about the condition, not just recognising the warning signs and acting quickly if you suspect someone is having a stroke, but also preventing it in the first place.
Clearer practical information
"We need to give people clearer, practical information about what a healthy diet actually means, how to make healthier choices when doing our grocery shopping, and the impact that a sedentary lifestyle can have on our health. These are skills that should be taught from a young age and embedded into our national school curriculum."
While stroke survival rates have improved, Ms Gómez Maestre says survival is only part of the picture. Stroke can have a significant and lasting impact on people's quality of life. It is estimated that about 90,000 people are living with the effects of stroke in Ireland.
Post-stroke care and support play a crucial role in helping people regain their independence and live life to the full. Croí provides a range of services and supports for people living with stroke and their families in the community.
"Our new Joe and Helen O’Toole Community Stroke Hub in Newcastle, located close to Galway University Hospital, is at the heart of our stroke support services. The hub provides a welcoming space where stroke survivors and their families can access support, connect with others, and take part in programmes that support life after stroke. We run monthly stroke support groups for stroke survivors and families as well as a dedicated group for family carers and the All Talk group which supports people living with post-stroke communication difficulties.
"The hub is also home to programmes including MyStroke, Rebuild, and ACTivate Your Life, alongside gentle exercise classes such as yoga, Pilates, and Tai Chi. We also run workshops, art classes, and other activities throughout the year."
The local heart and stroke charity's support extends beyond Galway, with a monthly stroke support meeting taking place at the Leisure Centre in Castlebar, Co Mayo.
She describes these support services as "incredibly important" for stroke survivors. "Recovery does not stop
when someone leaves hospital. Living with stroke can bring many physical, emotional, and social challenges and having somewhere to turn for information, support, connection, and practical help can make a real difference to people and their families."
• If you or someone you know has been affected by stroke and would like to find out more about the supports available, contact the Croí Connects Helpline at (091 ) 332999.
